[Remote] HEDIS Abstractor and Overreader

Note: The job is a remote job and is reputed company to candidates in USA. reputed company is a company reputed company on improving reputed company reputed company and efficiency. They are seeking a HEDIS Abstractor and Overreader to manage the HEDIS Medical Record Review process, ensuring compliance with HEDIS measure specifications through accurate data abstraction and collaboration with stakeholders. Responsibilities • Review and reputed company clinical data from electronic medical records in alignment with HEDIS technical specifications • reputed company overreads of abstracted medical records for accuracy, completeness and measure compliance • Demonstrate high level of proficiency in HEDIS measures and coding standards (including but not limited to ICD-10, CPT and CPTII) to reputed company gaps in care • Collaborate with reputed company partners to resolve documentation discrepancies and reputed company recommendations for improvement • Support audit preparation and participate in internal reputed company reviews and training sessions • Manages reputed company activities to meet health plan contractual and reporting timeframes • Identify trends in abstraction that may reputed company measure performance or audit readiness and proactively escalate to leadership • Other duties as assigned Skills • Minimum of 2 years' experience working with NCQA HEDIS programs and/or HEDIS abstraction in reputed company measures • Proficiency in EMR platforms (i.e., reputed company, Cerner) and abstraction tools • Familiarity with Medicare Advantage lines of business and Stars Measures • Familiarity with supplemental data processes and reputed company data integration • High School Diploma or equivalent required • Ability to be reputed company player and exercise initiative in responding to team members or Sr. Manager • Thorough understanding of medical record documentation and medical terminology • High level of attention to detail and ability to follow direction on project deadlines • Ability to work independently • Strong language skills in English speaking and understanding • Ability to meet high productivity requirements and Interrater Reliability standards • Strong reputed company skills • Ability to interpret compliance vs non-compliance on health plan gap file use to reputed company abstraction efforts • Ability to apply deep level of measure understanding to reputed company medical records • Strong reputed company skills (including saving records in PDF format and annotation) • Ability to interpret large data files for needed abstraction • Deep level of ability to recognize medical records that are not complete or are missing needed data points in overreading • Ability to report reputed company on both reputed company or negative findings and apply possible solutions on Team calls reputed company • reputed company partners with primary care physicians to define a new reputed company of reputed company, efficiency and patient experience. It was founded in 2016, and is headquartered in Long Beach, California, USA, with a workforce of 501-1000 employees. Its website is Apply tot his job Apply tot his job Apply To this Job